Fentanyl and OnabotulinumtoxinA interaction

Fentanyl and OnabotulinumtoxinA: the Fentanyl prescribing label describes an interaction that usually calls for monitoring, a dose change, or spacing the doses.

Moderate

Usually manageable with monitoring or a dose change. Tell your pharmacist you take both.

What the FDA labels say

From the Fentanyl (FENTANYL CITRATE) label · effective 2026-04-07

Moderate

• Risks of Skeletal Muscle Rigidity and Skeletal Muscle Movement : Manage with neuromuscular blocking agent.

Warnings and precautionsby drug classView label on DailyMed
Moderate

These effects are related to the dose and speed of injection and its incidence can be reduced by: 1) administration of up to 1/4 of the full paralyzing dose of a non-depolarizing neuromuscular blocking agent just prior to administration of Fentanyl Citrate Injection; 2) administration of a full paralyzing dose of a neuromuscular blocking agent following loss…

Warnings and precautionsby drug classView label on DailyMed
Minor

The neuromuscular blocking agent used should be compatible with the patient's cardiovascular status.

Warnings and precautionsby drug classView label on DailyMed

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Not medical advice. Interaction Checker quotes FDA label text and NIH fact sheets. Whether an interaction matters for you depends on doses, timing, kidney and liver function, and other conditions. Confirm with a pharmacist or prescriber.